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Special Feature

Consequences of Untreated Mental Illness

Have you interacted with someone who has mental illness? There is a high possibility that you have, and that’s because the prevalent rate of mental disorders is increasing throughout the world. In 2010, WHO reports that around 450 million people experience mental or behavioral disorders (WHO 2010) Given the increasing rate of mental illness or mental disorders, you may have interacted with someone with mental illness. If so, during your interaction with that person, you may have noticed that that person is unable to recognize and understand other’s feelings from facial expressions, or carry on a conversation and stay on topic. That’s because mental illness has to do with the mind. Since mental illness has to do with the mind, don’t be surprised if you notice that a person diagnosed with mental illness may not recognize the fact that something is wrong with them.

Mental illness is as serious as any medical condition. Unfortunately the lay public (and some unenlightened educated) not seeing physical injury down plays mental illness, with serious consequences. Mental illness is not as a result of personal or individual weakness or poor upbringing. It can affect any person any time irrespective of age, race, religion or income. Of course, there are cultural specific mental illnesses, eg. Anorexia nervosa in Western countries, koro in African and Oriental societies but there are common threads that run through all mental illnesses… To meaningfully assess and treat mental illness, the afflicted person’s primary language and culture are important mileposts. It is also important to note that there are some mental illnesses, which are irrespective of culture, ie. Schizophrenia which has a worldwide prevalence of about 1%. Thus resources must be made available to treat mental illnesses, the same as would be done for medical illnesses.

In many third world countries, supernatural beliefs and “over religiosity” contrary to scientific understanding mask mental illness even more. These along with social stigma makes this a tough disease to control or cure in many African societies. Public mental health education is seriously needed. (For example, epilepsy suffered a similar fate in developed countries several decades ago but with concerted professional and public health education, that is no longer the case here. A key breakthrough came when the public was made to understand that epilepsy was not contagious!).

The treatment of serious mental illness today is highly effective, if taken serious, treated with a combination of pharmacological and psychosocial therapies as well as supports, not stigmatization or joking about. Nowadays approximately 70 to 90% of afflicted individuals have significant reduction of symptoms and improved quality of life, if treated early and consistently.

Serious mental illnesses include major depression, schizophrenia, bipolar disorder with or without rapid cycling, post-traumatic stress disorder, panic disorder, obsessive compulsive spectrum disorder like kleptomania, borderline personality disorder, sexual paraphilia’s, bestiality, “theft addicts”, etc and other conditions that are grouped under criminal insanity.

The causes of mental illnesses are numerous. Among them: family history or genetics, neurochemical imbalances, external factors such as trauma (as in postwar countries), disease or injury, exogenous drugs, life experiences and poor coping mechanisms, societal and cultural maladaptive processes, and abnormal neuropsychological factors.

The WHO (World Health Organization) reports that four of the 10 leading causes of disability in the US and other developed nations are mental illnesses and projects that by 2020 (ie 8 yrs from now), the leading cause of disability in the entire world and children will be major depressive illness. Just imagine Liberia, post war, with either lip service or no service to treating mental illnesses. It must be made clear that attending church or “laying of the hands and prayers by reverends” will not cut it. These just delay the inevitable. Afflicted individuals need clinical help not religious help, contrary to the current trend in Liberia.

Recovery from mental illness is accelerated and further harm related to the course of mental illness is minimized if early identification and clinical treatment are promptly instituted. However without treatment the consequences of mental illness for the individual and society at large are staggering and can be devastating: unnecessary disability, unemployment, hard core substance abuse and the crimes that comes with it, homelessness, suicide, wasted lives, potentially dangerous dissociative disorders (that is currently so rampant in Liberia, via personal interviews and communications, 2/4/2012) and more worrisome, increase in violent crimes and tendency to general open hostilities tilting us back to civil war.

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The problem is further compounded if you have a ministry of health (headed by a surgeon- a big no, no in any forward thinking society after such a horrific and horrendous national calamity) that is unable to appropriately stratify and prioritize these medical and mental health needs of the society. Thus you will get what you get-ie more tragedy, more danger for all and a lurking time bomb.

“The focus of the DDRR program (Disarmament, Demobilization, Rehabilitation and Reintegration) was just to get the arms away from the ex-combatants and now we are experiencing the repercussions of a failed demobilization program relating to the psychosocial needs and mental wellbeing of the ex-combatants. The repercussion is glaring in the streets of Monrovia, the capital city and the rest of the 15 political subdivisions where young girls and boys, women and men roam and ramble crazy in the streets while ghettos continue to be crammed by the day with hopeless wild youths, who regard marijuana, cocaine and other illegal drugs and harmful substances as forms of appeasement for their mental torment.”- Dr. Benjamin Harris, 2008, IRIN News.

To add to that toxic mix is someone with ill intent to program these kids like the zombie “Manchurian candidate”, and the next thing we hear is pooffff and there we all go again, that is all of us this time around!!!

Forewarned is forearmed. We can’t wish mental illness and its consequences away. Prayers will not cut it either. For if that were so, all those decades of prayers and with the plethora of churches all over Liberia currently , we should have been able to cure mental illnesses thru these routes ever since. No lip service, no criminal diversion of funds, roll up our sleeves and we all pitch in. Not the usual Liberian way of impugning the patriotism of others and riding them on guilt shake down trip. That just won’t work. Many are shining their eyes more than ever before. Those who are paid the bucks to do these things must start the genuine efforts and then the rest of the population will follow. Not the other way around, as usual.

Need I say more?

Lawrence A. Zumo, MD
Diplomat, American Board of Psychiatry & Neurology
Member, American & European Academy of Neurology
International Advisory Board Member, Journal of Parkinsonism & Restless Legs Syndrome, ww.jprl.org

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